Isolation of drug delivery from drug effect: problems of optimizing drug delivery parameters.

A recurring question in the treatment of malignant brain tumors has been whether treatment failure is due to inadequate delivery or ineffective drugs. To isolate these issues, we tested a paradigm in which the "therapeutic" agent was a toxin about which there could be no question of efficacy, provided it was delivered in adequate amounts; we used 10% formalin. We infused 10% formalin into 5- to 8-mm subcutaneous RG-2 and D54-MG gliomas at increasing rates until we achieved 100% tumor cell kill.

Impact of socioeconomic status on the diagnosis to treatment interval in Waldeyer's ring carcinoma.

Objective: To examine the impact of socioeconomic status on the diagnosis to treatment interval in Waldeyer's ring cancers by comparing the experience of a public hospital and an academic tertiary care medical center.

Design: Retrospective review.

Setting: Otolaryngology clinic of a public hospital and an academic medical center.

Arterial reconstruction by direct surgical clipping of a basilar artery dissecting aneurysm after failed vertebral artery occlusion: technical case report and literature review.

Objective And Importance: Dissecting aneurysms of the basilar artery are rare lesions with significant morbidity and mortality. Their management is controversial and often difficult. Although the rebleeding rate is high, clip reconstruction carries prohibitive risk because of the damage to the parent vessel induced by the dissection and the lack of tissue to gather.

Coiling of cerebral aneurysm remnants after clipping.

Objective: During the past decade, options for the management of aneurysm remnants after clipping have expanded. Advances in aneurysm coiling techniques and technology have allowed for more remnants to be treated safely. We present our experience with this approach and discuss its indications, limitations, and results.

Trapping and revascularization for a dissecting aneurysm of the proximal posteroinferior cerebellar artery: technical case report and review of the literature.

Objective And Importance: Subarachnoid hemorrhage caused by an isolated dissection of the proximal portion of the posteroinferior cerebellar artery (PICA) is a rare problem. The optimal treatment to use for patients presenting with this clinical scenario varies and therefore is controversial in the literature. We report a patient in whom this problem was treated effectively with trapping of the diseased segment and revascularization of the PICA.

Spontaneous thrombosis of a residual arteriovenous malformation in eloquent cortex after surgery: case report.

Objective And Importance: The presence of a residual arteriovenous malformation (AVM) on postoperative angiograms is typically an indication for prompt return to the operating room to complete resection, because of the risk of early hemorrhage. This approach, however, may involve risks of neurological deficits when the residual AVM is in eloquent cortex. We present a case of complete thrombosis of a residual AVM after surgery.